Leung K L, Tsang K S, Ng M H L, Leung K J, Lai P B S, Lee J F Y, Lau W Y
Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
Surg Endosc. 2003 Aug;17(8):1305-10. doi: 10.1007/s00464-002-9172-4. Epub 2003 May 6.
Laparoscopically assisted resection of colorectal carcinoma is technically feasible and minimally invasive. Postoperative immunosuppression also may be reduced. This study compared the lymphocyte subsets and natural killer (NK) cell cytotoxicity in patients after laparoscopically assisted resection with those after open resection of rectosigmoid carcinoma.
In this study, 40 patients with rectosigmoid carcinoma, but no evidence of metastasis, were randomized to receive either laparoscopically assisted or conventional open resection of the tumor. Blood was collected before the operation, then 24 h, 72 h, and 8 days after the operation for studies of lymphocyte subsets and NK cell cytotoxicity.
The lymphocyte subsets and NK cell cytotoxicity of both groups showed typical suppression after surgery. The suppression of T cell activation and NK-like T cells was significantly less after laparoscopically assisted resection than in after open resection, whereas the difference in other lymphocyte subsets and NK cell cytotoxicity was not significant.
This study showed that some cellular components of the immune system are less suppressed after laparoscopically assisted than after conventional open resection of rectosigmoid carcinoma. This may have implications for tumor recurrence and long-term patient survival.
腹腔镜辅助下结直肠癌切除术在技术上是可行的,且具有微创性。术后免疫抑制也可能减轻。本研究比较了腹腔镜辅助下乙状结肠癌切除术患者与开放乙状结肠癌切除术患者术后的淋巴细胞亚群及自然杀伤(NK)细胞细胞毒性。
本研究将40例无转移证据的乙状结肠癌患者随机分为两组,分别接受腹腔镜辅助肿瘤切除术或传统开放肿瘤切除术。于术前、术后24小时、72小时及8天采集血液,用于淋巴细胞亚群及NK细胞细胞毒性研究。
两组患者术后淋巴细胞亚群及NK细胞细胞毒性均呈现典型的抑制状态。腹腔镜辅助切除术后T细胞活化及NK样T细胞的抑制程度明显低于开放切除术后,而其他淋巴细胞亚群及NK细胞细胞毒性的差异无统计学意义。
本研究表明,与传统开放乙状结肠癌切除术相比,腹腔镜辅助下手术对免疫系统某些细胞成分的抑制作用较小。这可能对肿瘤复发及患者长期生存产生影响。